2013 Billing Instructions

2013 Billing Instructions

2013
Billing Instructions

This is in connection with attached agreement between you and Johnson & Johnson Diabetes Institute, LLC (JJDI). The description of services and fees are detailed within the agreement and should correspond to the description in this invoice. Subsequently, a service description and payment by category form has been provided on page two of the 2013 Billing Instructions.

A completed invoice is required before any payments can be processed for the services you provide.

Payment will be delayed if it does not include the following information to its entirety:

  • Consultant Name
  • As it appears in the contract
  • Consultant “Remit To” Address
  • If the address on the invoice does not match that of the contract, the payment will not be made.
  • Consultant Phone Number
  • Invoice Date
  • Contact Person at JJDI – Adrian Rios
  • HCC Agreement Number – You have a new HCC Agreement number for 2013.
  • Please do not include any prior numbers; payment will not be made on them.
  • Keep this number with you as you will need to include it on each invoice you submit.
  • Do not submit an invoice without your 2013 contract number.
  • Description of Services provided by session or service date and category. See page 3.
  • Travel expenses must be itemized and identified in each line item provided.
  • Rental Cars must be booked and paid for by the JNJ Travel Desk. Invoices that include rental cars will be returned to you and you will need to resubmit a new invoice form as rental car charges will not be reimbursed.
  • Amount to be paid, i.e., per diem or itemized by hour.
  • All invoices need to be signed and dated by you, or they cannot be processed.

Please email your invoice (with scanned copies of original travel receipts*, if applicable) to:

Adrian Rios at email address:

Note: Please do not mail your invoice(s).

If receipts are not legible, this will cause a delay in your payment.

INVOICE
CONSULTANT INFORMATION / TODAY’S DATE / CONTRACT #
Name: / 01/01/2013 / HCC#
Address:
JJDI CONTACT PERSON
Adrian Rios
Phone:
ITEM / PROJECT DETAILS / AMOUNT
Consulting Arrangement / Activity Date (s):
Description of Services: / $0.00
Payment Categories
And Invoice Guideline
(Identify A, B or C,
also See Page 3) /
  1. Per Diem: $2500
  2. Hourly Category 1: Presentation
  3. Hourly Category 2: Content Development
/ _____
*Travel Expenses (if applicable)
(Please attach all original receipts. Expenses will not be paid unless receipts are submitted.) / Airfare: $______
Hotel: $______
Meals: $______
Other: $______/ $0.0
Personal Car Mileage (if applicable)
(Reimbursed @ $.55 per mile) / Miles Driven: ______
From Location:
To Location: / $0
TOTAL
/ 0.00

I hereby certify that the services as more fully described in the contract (contract number stated above) were performed as required by JJDI and all original receipts attached represent reasonable documented expenses incurred in connection with the services.

Consultant (Signature)
Date

Service Description

Payment by category

Category / Description / Invoice
Amount
Per Diem /
1 full day of JJDI Facilitation or Faculty / $2500
Hourly
Facilitation or Faculty /
Presenting at ADA, AADE, 1 hour Webinars
This category is reserved for instances when you are presenting a topic at a JJDI event or an event attended by JJDI. / $300
Hourly
Content Development /
This category is reserved when contracted to review slides or develop content, i.e., pediatric program or any of the topics in our adult program, i.e., reimbursement slides. Edits to the class flow or faculty agenda. All conference calls i.e., team preparation calls and HCC and any training under 8 hours. / $150

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Updated: 01/11/12

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